Clinical Team Lead - Customer Service Access Center

Lead Clinical Representative, Customer Service (Access Center)

Exciting remote opportunity to join an expanded centralized clinical team supporting BJC Medical Group primary care clinics!

The Lead Clinical Rep, Cust Svc (Access Ctr) provides remote clinical support by performing a variety of clinical duties such as managing medication refill requests, prior authorizations, and responding to patient messages through the electronic health record (e.g., MyChart). The ideal candidate will possess prior experience in a primary care or ambulatory healthcare setting, preferably as a Medical Assistant or similar clinical support role. Successful candidates will demonstrate strong attention to detail, effective communication skills, sound clinical judgment within scope, and the ability to manage multiple priorities in a fast-paced environment.

Monday through Friday 8 a.m. to 4:30 p.m.

Overview

BJC Medical Group is the multi-specialty physician-led organization of BJC HealthCare and includes over 600 doctors and advanced practice providers who are affiliated with top-ranked hospitals in the Midwest region.

Since 1994, BJC Medical Group has provided access to extraordinary care in over 145 locations and over 25 specialties in the greater St. Louis, mid-Missouri and southern Illinois areas. Our providers are nationally recognized for excellent patient satisfaction, quality health care, and improving the health and well-being of the communities we serve.

Responsibilities

• Manages a high volume of incoming calls from patients, healthcare providers and facilities who are calling for a variety of reasons, to include scheduling appointments, refilling medications, obtaining insurance referrals, receiving symptom-based care, obtaining pre-certification for testing, insurance and/or billing questions, requests for medical forms and/or test results, etc.; ensures resolution of the caller need.
• Leverages critical thinking with speed and accuracy to identify reason for the call and take appropriate action based on caller need and acuity; researches complex issues in the electronic health record and consults/escalates to clinical staff when necessary; leverages multiple job aids and resources to provide appropriate level of service.
• Navigates the electronic health record to obtain and validate historical information; captures and documents clinical and financial information in the electronic health record; maintains accountability for accurate data entry in the electronic health record and maintains patient privacy and security as outlined by HIPAA.
• Schedules patient visits based on multiple complex provider preferences; verifies and updates insurance and checks insurance eligibility; collects and documents demographics; maintains proficiency in and shares knowledge of insurance basics, MyChart, and appointment instructions; documents and sends messages to providers and clinical staff in the electronic health record for clinical-based needs; communicates directly with providers (physicians) to relay pertinent clinical information during after hours.
• Manages calls within established performance and customer service standards; achieves targeted abandoned call rate, average speed of answer, and average transaction time; provides excellent and consistent customer service in a variety of situations; communicates in a professional, positive, and respectful manner with patients, providers, BJC staff and external organizations; provides subject matter expertise for peers, assists with training of performance and customer service standards, and assists with process or technology issue resolution; updates and manages provider call schedule with changes during after hours.
• Assists with candidate interviews and provides training and coaching to new and existing team members; manages escalations regarding process/department questions, technology issues, and customer service complaints and questions.
• Completes proactive quality audits of performance standards; reports operational performance metrics; monitors daily call stats and supports workforce management activity to shift staff based on call volumes.
• BJC has determined this is a safety-sensitive position. The ability to work in a constant state of alertness and in a safe manner is an essential function of this job.

Minimum Requirements

Education

• High School Diploma or GED

Experience

• 5-10 years

Supervisor Experience

• No Experience

Preferred Requirements

Education

• Associate's Degree

Supervisor Experience

• < 2 years

Benefits and Legal Statement

BJC Total Rewards

At BJC we're committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance* paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

*Not all benefits apply to all jobs

The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer